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Am I Depressed?

Margaret Denise Brauns, MS, LMFT

Important considerations about depression.

Clinical depression, like any health condition, will manifest itself differently in every individual. Symptoms, duration, intensity and experience of a depressive episode is unique to each person. Appropriate and effective treatment for sufferers of depression will vary. It is normal to question or feel worried about how long we will be depressed. Many wonder "will I ever feel normal again". Other thoughts include, “I don’t feel like myself” or “I’m afraid I will never be myself again”.

Depressive episodes and symptoms can be frightening. 
Symptoms may include fatigue, reduced motivation, detachment, lack of joy and hopelessness. These feelings exacerbate fears about our future and recovery. Many report feeling that a “dark cloud” is lingering or experience feeling detached from work and loved ones. Others feel unable to experience pleasure from activities that were previously enjoyable. Each of these aspects of depression can create a block to believing that life or one's emotional state will return to what we once knew.   
 
Further exacerbating worries about recovering from depression include a misconception that depression is a choice or a state of mind. While moods, or reactions to emotions can be manipulated by thoughts or controlled responses, clinical depression is a health condition that impacts individuals both physically and mentally. While mental health conditions do affect the mind and thinking process, this does not suggest that diagnosable mental health conditions are elected or influenced by one’s will power. 
Misconceptions about depression and other mental health conditions can exacerbate symptoms, leaving one feeling that if they were stronger or had more self-control, they would not be depressed.
It is important to understand that clinical depression is a health condition: it can be as disabling as any other health condition, even life-threatening. Further, clinical depression is a physical health condition as much as it is a mental health condition. Physical symptoms of depression include fatigue, joint pain, loss of appetite or insomnia. Equally as real and disabling are the mental symptoms including deep sadness, irritability, disorganized thinking or hopelessness.
Symptoms of clinical depression include the following:
  • reduced interest in activities that are normally pleasurable
  • insomnia or increased need for sleep
  • lack of appetite or an increased need to eat, leading to either weight loss or gain
  • restlessness, irritability, or lack of energy and fatigue
  • trouble concentrating and attending to usual tasks
  • poor self-image
  • suicidal thoughts

It is helpful to understand that recovering from depression is similar to recovering from any other health condition. 
Imagine that you are recovering from a knee surgery or pneumonia: would the expectation about work productivity or participating at home be the same? Could you accept a doctor's or therapist's response that recovery time will vary and agree not to rush back into stressful routines?
With mental health conditions, we tend to judge ourselves for negative feelings or not coping better. Further confusing, loved ones often try to help with statements such as “cheer up” or “what do you have to be depressed about…? You have a good life”. While these statements may be intended to be helpful, they frequently have the opposite impact. Remarks such as these can reinforce that the depression is a choice or elected mood. Patience and simple supportive statements such as “I’m sorry you are feeling so badly,” or” let me know if there is anything I can do to help” are more helpful.

The best path to recover from episodes of depression include medical and social support, rest, healthy diet, adequate sleep, and minimizing stress; when you are ready, slowly add activities back into your life. These recommendations are similar to many comprehensive suggestions for recovering from other health conditions such as the flu, surgery, or traumatic life events.

Nearly every individual experiences at least one major depressive episode in their lifetime. 
Understanding and having empathy for yourself or others during times of vulnerability is essential to recovery. With ample information about depression and treatment available, seeking help from supportive family members and professionals can assist in the recovery process. With rest, treatment and support many patients committed to recovery find themselves feeling better in six weeks to three months. However, depending on your diagnosis, individual circumstances, and the type or severity of your depression, your recovery time will vary. 

If you or a family member is suffering from clinical depression, it is important that you seek medical help.
You can expect a physician or mental health professional to be supportive and provide you with valuable information. While depression can be situational and improve independently of outside support, it is critical to seek help when there is interference with one's daily life, thought patterns, or functionality. Clinical depression can be life threatening. Untreated, depression can contribute to additional health conditions related to neglected self-care or substance abuse.
Be proactive and persistent when seeking support for clinical depression.
Rarely one regrets asking for help; delaying or not seeking needed mental health treatment is the regret.

Today, accept the help you need with mental health conditions and allow yourself adequate time to recover.

By Margaret Denise Brauns, MS, LMFT 21 Mar, 2021
Anxiety is often the underlying cause of physical symptoms mistaken for other health conditions. We frequently believe we have a serious medical condition long before we recognize we have anxiety, or even consider an anxiety disorder. It is not uncommon for clients, specifically adults, to deny having anxiety but readily admit to worrying constantly. A recent study from the National Institute of Mental Health revealed that nearly 70% of Americans suffer from at least one type of anxiety disorder. This report should be of no surprise: we live in a culture where chronic stress is an accepted part of daily life. At early ages, we are indoctrinated with suggestive messages that busy is healthy, we must perform faster, accomplish more, and demonstrate success by perfection-based ideology. Having been conditioned to believe that more is better, we frequently add too many things to our plates. We have difficulty setting boundaries and saying no. Many believe they thrive when busy and even express a sense of pride when discussing a relentless schedule. The inevitable outcome of a life packed full with every minute accounted for, is overwhelm, burnout, and chronic anxiety. In my experience, clients easily express a desire to feel less overwhelmed and have more leisure time. However, when asked to let go of unnecessary commitments, there is resistance. Inevitably, after living with chronic stress for long periods of time, the norm may be feeling anxious. A change that creates open time and space, can create a " time void " that is uncomfortable. In fact, letting go of anxiety or stressors can actually be anxiety- provoking. To combat chronic anxiety, clients must commit to reducing stress, as opposed to “managing stress”. Stress in life is unavoidable and it is true that some individuals have less stressful lives due to advantageous personal circumstances. Regardless, of our circumstances, it remains common to accept unmanageable workloads, entertain stressful relationships and continue adding activities to full schedules. For change to occur, we must let go of habits that leave us mentally and physically depleted. You can choose to fill the "time void" with self-care which may include rest. Americans have learned to accept chronic anxiety as a way of life, even knowing of the negative implications on our health and relationships. Health experts have concluded that chronic stress reduces our life span by an average of 6 years. The goal in my office is stress reduction. If your life feels overwhelming and unmanageable, you must make choices to change it. Trying to manage the unmanageable is a losing battle. Pay attention to how often you hear or use the term stress management. Identify activities you don't need to do such as attending a social function where you know few people or cleaning an already tidy house. Learn to put your health first by prioritizing time for rest and recharging. The elimination of unnecessary stressors and reduction of chronic anxiety will increase your lifespan and improve the quality of your life. The number of stressors you have is generally a choice. How you respond to stressful events is also a choice. Learn how to eliminate stress and reduce anxiety. You can respond to life in ways that create opportunities for living the life you want.
By Margaret Denise Brauns, MS, LMFT 20 Mar, 2021
Benefits of Journaling Journaling has regained popularity in recent years in mental health. It has once again become a tool for a variety of mental health conditions including anxiety, depression and reducing stress. Whether you are in therapy or on a path of self-discovery, writing your thoughts and experience is is valuable. Research has proven that strategic, committed journaling can actually change the way one thinks, feels and behaves. Studies reveal that individuals who commit to 30 days of writing daily in a gratitude journal, report significant improvement in their positive outlook on life. An additional benefit is that success in journaling is not impacted by financial circumstances, education, age, or writing skills. Journaling only requires a desire and commitment to the process. While there are technically no wrong or right ways to journal, there are strategies to help get you motivated to begin. Ask yourself about the value you see in journaling and if you can to commit to the process. Discuss lack of motivation or resistance with your therapist or someone who successfully journals. Try following general guidelines to help get you started or research journaling prompts. Tips for Journaling: Buy or find a journal you’d like to use. Keep it in a secure but accessible place. Commit to writing every day for 30 days. Keep going if you enjoy it! Set a consistent time aside each day for journaling. It doesn’t need to take 1 hour; start with a 5-minute commitment. Once you begin writing, keep your momentum going. Write anything that comes to mind… Write honestly. While journaling is a creative form of writing, in order to gain self-awareness, it is not intended to be fictional. Accept that journaling is not about using correct grammar or perfect writing skills. Allow yourself to be spontaneous. Be confident that no one is going to read your journal. (If you believe there are boundary issues in your home, learn how to set boundaries. Keep your journal at work or in a locker at school if you must.) If you feel blocked in writing, use prompts from journaling books or websites. Try gratitude journaling, or focus on journaling about something of interest to you. (i.e. parenting, relationships, childhood memories). Do not critique or judge your own writing. The key is honesty and spontaneity. Make sure you are not censoring your writing. Ask yourself if you are writing what you think should do or feel or if it is what you really feel, what really happened or what you wish happened? Look forward to the self-discovery in your writing. Even facing hard truths leads to a more peaceful way of living. Do not be stingy with yourself about journals if possible. Buy a cover you enjoy and replace journals frequently. When you are ready to start a new journal, do it. Some people ceremoniously burn or destroy journals when complete. Develop your own traditions with journaling. Have fun with it and enjoy the process. Just get started. The longer you journal, the sooner you will develop a routine and style that works for you. Allow yourself to discover your truth through journaling. It is an excellent tool in the process of self-awareness and change. Self-awareness can help you understand your emotions and behaviors and can create opportunities for change. Journaling is easy, inexpensive, and well worth the effort. Today is a great day to begin journaling.
By Margaret Denise Brauns, MS, LMFT 19 Mar, 2021
Relationships suffer with unresolved conflict. Even strong relationships become vulnerable when problems occur and no resolution is in sight. Unresolved conflict that becomes circular, hostile and resentful can chip away at the foundation of any relationship. Learning the art of apologizing and forgiveness is critical in relationships. We all have days when we are not our best self and we make mistakes or poor choices. "To error is to be human". When our words, decisions, or mistakes hurt others, intentionally or not, we must learn to apologize. Resolving conflict with grace brings us closer together: unresolved conflict can break down any relationship. Apologizing can be difficult; it is natural to feel justified in action or not want to accept responsibility for mistakes. Barriers to apologizing include disagreement about the problem, or the fear of admitting we are wrong. Feeling vulnerable when we apologize is common. It is most important to understand that we can increase intimacy and strengthen our relationships by learning to apologize. Apologizing can be this simple: 1) State with sincerity that you are sorry 2) Identify what you can do better 3) State your intention to respond differently in the future. 4) Be willing to listen to feedback without defending your actions. 5) Accept that forgiveness may take a little time. Forgiveness is Underrated While apologizing can be hard, forgiving others when we feel wronged can be even more difficult. Once you have received a sincere apology, it is a choice how to proceed. Forgive the offense or harbor resentment? Choose to trust the sincerity or make exit plans? Holding onto resentments or past events will eventually lead to the unraveling of relationships. Practice forgiving even when it is difficult. Forgiving can leave us feeling vulnerable: we are fearful that we may be hurt again. Learn the skills to apologize and the skills to forgive. Forgiveness of others is a true statement of love. In forgiveness we are saying, I love and value you even though we are both imperfect. When we forgive others, we are able to free ourselves of anger and negativity that hurts us. We are also able to reopen the door to communication and intimacy in our important relationships. “Forgiveness is the truest form of love. It takes a strong person to apologize and even a stronger person to forgive." Today is a great day to learn how to apologize and how to forgive.
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